Rahul Kumar (Hyderabad): I am 22-years old having 5 feet 8 inches height and weigh 76 kg. I tried Yoga, running, exercises and bit of dieting but didn’'t get the results. The chief reason can be my busy schedule as I have only 30-45 minutes in a day for these activities. I smoke and drink, but have reduced both. My father and has a high BP and it’s hereditary. So please suggest me some measures to overcome this problem.
Dr Anoop Misra: Your ideal body weight should be around 70 kg. Forty-five minutes of brisk walking daily including 10 minutes of jogging (or a similar aerobic exercise) and a balanced diet high in fiber (oats, wheat bran, sprouts and whole dals) is advised. Avoid having aerated drinks, fried foods and refined cereals like poori, parantha, pakora, samosa, white bread, naan, kulcha and bakery stuff. Please stop smoking and reduce alcohol intake further.
Vandana Singh (New Delhi): I work as a sub editor so mine is a desk job, I have to sit continuously for hours. It leads to heavy weight gain especially in the stomach, lower abdomin and buttocks. Please help.
Dr Anoop Misra: Vandana, since you have a desk job, it is advised that instead of sitting continuously you should take a small walk after every 1- 1 ½ hrs. Some brisk walking everyday (45 minutes a day) and a balanced diet (high in fiber and low in fat) would help you keep in shape. You can also consult physiotherapist or exercise trainers for specific exercises to tone up muscles in abdominal area.
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Mangesh Pisal (Thane, West): I am 28-years-old and I was 160 kg when is started losing weight. I lost nearly 50 kg by protein diet and work out twice a day. I got married last year and now it is hard to maintain the type of diet and workout. I have gained 15 kg in no time and now it is hampering my personal life. I was thinking of going for liposuction can you tell me pros and cons of it.
Dr Anoop Misra: Liposuction would only give temporary and cosmetic benefit. You should go back on your previous diet and exercise schedule and lose weight again. However, if your body mass index still remains above 40 kg/m2, consult a surgeon specializing in bariatic surgery.
Saurabh (Bangalore): I am a 24-year-old software engineer from Bangalore. I have a strange problem, I don’t overeat or for that matter I don’t eat junk food, oily food, exercise regularly (that includes two hours of hard gym,15 minutes of running,15 minutes of cycling and at least 4-5 kms of walking everyday). I am still overweight and I am just fed up and irritated as all my fat shows up on my face(cheeks) while the rest of my body is fine.
Dr Anoop Misra: To know whether you are overweight or not we need to calculate your body mass index (BMI) with the help of a formula requiring height and weight. For Asian population BMI should be 23 kg/m2. Diet control and brisk walking for 45-60 minutes daily is essential for maintaining good health. To further know about your fat percentage you can get done your body fat analysis. This will indicate whether your body fat is within range or not. You should consult a metabolic specialist to investigate whether you have some other cause of fat accumulation.
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Smitha (Cochin): I am 27 years of age and 5\'4\" tall. My weight is approx 84 kg. I need your suggestions on what should be my weight be with my age/height ratio. And more importantly what is the best and a safe method to reduce my weight to normalcy.
Dr Anoop Misra: According to your height and your age your ideal body weight should be around 60 kg. The safest method to reduce weight is to follow a balanced diet (1400 Kcal), low in fat and high in fiber, along with brisk walking for 45-60 min/day. Therefore a combination of diet and physical activity is the safest method to reduce weight. Drugs also may be used when indicated.
Anilchadha (Rachi): I am well built about 176 cm 99kg, 54-year-old with maximum weight on my waist.
Dr Anoop Misra: Your ideal body weight should be around 75-80 kg. A combination of balanced diet (1200 Kcal; high fiber and low fat) and regular physical activity (45-60 minutes brisk walking) would help you loose those extra kilos. If you do not lose appreciable weight by these, medication for weight loss is warranted.
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Ramasubramani (Chennai): I am 23-years-old. I am working as a software engineer in Chennai. My weight has increased by 15 kg in one year. My height is 178cms. My weight is 78 kg. Kindly suggest whether I have balanced weight or overweight.
Dr Anoop Misra: The lifestyle of a software engineer gets very sedentary because of the odd and prolonged working hours with maximum time spent over the computer. Till now you do not seem to have fallen into the obesity category but you’re on the borderline. This is the time for you to become careful. At the same time get your metabolic profile including thyroid tests done.
Dr Meena Garg, MBBS,MD ( Pharmacology) (Secundarabad): I am 52-years-old, my height is 152 cm (5 feet) and my weight is 77 kg. I am married now for 22 years with two children. The younger one is 15. I used to weigh about 54 kg before marriage and gained 10 kg in each pregnancy, both deliveries were by Caesarean section. My excess weight is basically around hips and abdomen. My TSH, T3, T4 we normal, I am not diabetic and my BP is normal. I have tried all possible therapies including anorexia pills with very disappointing results. My mother is and maternal grandmother was plump.
My body otherwise is so flexible that even now I can bend and put both the palms flat on the ground/floor. I am more worried now as my knees are giving me lot of pain and ankles are also troubling. I don\'t have any backache problem.
Dr Anoop Misra: Your BMI is 33.3 kg/m2, which is very high. It is called morbid obesity. You must start intensive diet control and exercise. You should do brisk walking for 60-90 minutes daily seven days a week regularly. At your BMI, anti-obesity medicines are indicated. But before that Your Doctor will have to do your detailed examination and blood investigations. Thereafter it can be decided which drug would suit you. Recently newer medicine (rimonabant) has been launched which is effective.
Rajesh (New Delhi): I am a 23-year-old male working in a BPO in New Delhi. My weight is 90 kg. I don't have time to go to the gym and also I am unable to diet. Please tell me what should I do to lose my weight and what should be the idle weight for me as my height is 5\'8\.
Dr Anoop Misra: Your ideal body weight should be around 70 kg. If you cannot go to the gym because of the erratic work timings, then you can jog for 15-20 minutes daily whenever you have time, or you can keep stationary cycle at home and exercise when you watch TV. As far as diet is concerned you can regulate it by carrying your food from home rather than eating the food served over there. Have a balanced diet rich in fiber. Avoid having refined cereals (burgers, pizzas, nan and kulcha ), even fried foods.
Maulik Pandya (Gandhinagar): How is Orlistat 60 mg different from Rimonaban 20 mg? Can Orlistat 60 mg be given to overweight people without any co morbidity? How we can define obesity and overweight based on Waist Circumference? How we can differentiate patient profile for Sibutramine, Orlistat and Rimonabant use?
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Dr Anoop Misra: Both are different molecules. Usually Orlistat is given 120 mg three times day and leads to 5-15 per cent weight loss. Efficacy of lesser dose of Orlistat (60 mg/ three times a day) would be lower but with better adverse reaction profile Anti-obesity drugs are started if BMI is more than 27 kg/m2 with morbid diseases or is 30 kg/m2 without any morbid diseases. Waist Circumference should be less than 90 cm for males and less than 80 cm for females. After detailed examination and investigations we decide which antiobesity medicine can be given.
Puja (Chennai): I am 29-years-old. I am overweight and have psoriatic arthritis of knees. I want to lose weight but the arthritis makes it impossible to exercise. Can you suggest ways that I could use to lose weight.
Dr Anoop Misra: For losing weight you can follow a low calorie diet, high in fiber and low in fat (calculated according to the height and physical activity). However, only diet may not be enough for appreciable weight loss and concomitant antiobesity drugs should be given when indicated.
Sanober (London): I am gaining a lot of weight presently. My current weight is 78 kgs. My height is 163 cm and age is 41 years. My cholesterol level is also increasing. My waist is 40. Please advice.
Dr Anoop Misra: Your BMI is 29.3 Kg/m2. Your ideal body weight should be around 63 kg. If you have a problem of weight gain and high cholesterol levels, you should consult a physician close by for proper medical advice to find out the cause of weight gain and to start a lipid lowering therapy if required. Follow a proper diet and physical activity pattern.
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S Kumar (New Delhi): I am 52-years-old. I am 5.9 inches tall, weigh 90 kg. I am a diabetic. I walk one hour in the morning, and one hour in the evening. I am a vegetarian, non-alcoholic and a non-smoker. I had lost 20 kilos last year due to illness, but have gained back 20 kg. I am very active, and do a bit of yoga with panama art of living basics. Please advice on losing 15 kg permanently. My waist is 42 inches.
Dr Anoop Misra: Your BMI comes out to be 31 Kg/m2. Your ideal body weight should be around 72-73 kg. A low calorie diet (high in fiber and low in fat) planned with proper meal spacing and high fiber (oats, whole grain cereals and whole pulses etc) foodstuffs would help you loose weight. Along with the diet, regular physical activity (brisk walking/ cycling etc.) is mandatory. There are certain drugs such as metformin and rimonabant which can improve your diabetes control as well as help in weight loss and decrease in abdominal girth.
Sukanto Banerjee (Navi Mumbai): My mother is 75-years-old, she is suffering from obesity. She is 5 feet 1 inches tall but weighs more than 90 kg. She also suffers from artheritis that has restricted her movements considerably. She also suffers from constipation. She is also losing her control over urination.
All doctors consulted so far say that she must reduce her weight first. It is not that she eats a lot, but her restricted movements have brought about this condition.
Please advise.
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Dr Anoop Misra: In that case you need to pay attention on the type of food she is eating. She needs to have high fiber foods like plain oats, whole grain cereals, whole pulses (sprouts and dals), green leafy vegetables, and fruits like apple and papaya are advised. This would take care of her weight as well as constipation. She should also be given orlistat, a weight loss drugs which could additionally relieve her constipation.
Vinod Kumar Puthuseeri (Bangalore): I have been obese since childhood. I am 33 now and there has been no stop to putting on weight. I currently weigh about 114 kg and my biggest concern is my bulging tummy. My work is restricted to my desk with occasional travel to other departments. Have just begun to control on my eating habits, but do not see any changes. I always begin with some exercise program and end up within a week’s time, either because I get lazy or then there is something that came up. Please do advise if there is any alternative for weight loss and also reducing the fat contents from hip portion.
Dr Anoop Misra: If you have been putting on weight then first of all you need to be investigated properly (blood investigations and ultrasound) Only a combination of diet and 60 minutes daily of exercise done persistently would lead to weight loss, not when you do either alone. If you do not have any disorder that may cause weight gain (e.g. thyroid disorders) then certain drugs, given under a physician’s supervision, would lead to weight loss.
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Arief (Bangalore): I have been trying to keep my weight at bay since many years now but somehow weight gain tendency is more rather than reduction. I have done my lipid profile test that has indication of cholesterol on very high side. My present weight is around 100kg and my height is 6 ft. Due to high cholesterol I have been serious about weight loss and working out twice a day I have hardly lost weight. I have just lost five kg in nine months. I am not regular eater and don’t eat anything which adds to weight. Please advise.
Dr Anoop Misra: Your BMI is 36.7 kg/m2, which means you have morbid obesity and you should do diet control, exercise and start anti-obesity drug. Take 1200 Kcal diet, do 60-75 minutes of brisk walking daily either in the morning or evening. For your lipid profile, lipid-lowering medications are needed to reduce your risk of heart attack. If these measures fail, bariatic surgery for weight reduction is an option.
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